Active NPI
Elizabeth Flaherty
- Dentist
- Tucson, AZ
National Provider Identifier
1346985348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D14739
- Practice address
- 4175 S. Alamo Ave
Tucson, AZ 85707-4405 - Phone
- (520) 228-2650
- NPI assigned
- May 3, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D14739 | MN | Primary |
Addresses
Primary practice location
4175 S. Alamo Ave
Tucson, AZ 85707-4405
Mailing address
355TH Medical Group
4175 S Alamo Ave
Tucson, AZ 85707
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D14739 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691452800000",
"number": "1346985348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355TH MEDICAL GROUP",
"address_2": "4175 S ALAMO AVE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4175 S. ALAMO AVE",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857074405",
"telephone_number": "520-228-2650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLAHERTY",
"first_name": "ELIZABETH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-05-03",
"last_updated": "2023-08-08",
"certification_date": "2023-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D14739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.